Oh Wise Ones:  I need some assistance with a patient.  I think I've
exhausted all the obvious things and now I need to 'pick your brains' for
other ideas.

Mom of a very healthy, rather rotund 5 mo old boy has been leaking profusely
since her milk came in at 3 days.  She has a hx of severe endometriosis and
infertility.  I saw them for the first time two weeks ago and in fact this
mom sprays milk across the room for a good 5 minutes after MER!  This is not
just a case of "overactive letdown" as the pressure never seems to fully let
up throughout the feeding.  The mom has great instincts and without any help
started nursing off just one side at a time several weeks after birth.
During an earlier phone call with her, I suggested nursing "uphill" and
using a sitting up position for baby.  These helped with the baby's choking
and to some degree with intestinal colic (caused probably by too much
lactose and gulping air), but she is really getting frustrated.  She wants
to bf until baby naturally weans but she is really getting sick of leaking.

I managed to get her some BLIS (breast leakage inhibiting system) for her
daytime work (she brings baby with her to her job) and they are working
great.  However, if she wears them at night, she awakens engorged.  If she
doesn't wear them, she and baby are drenched.  I advised against wearing
them at night bec she awakened with hard hot breasts one morning.  The good
news is that the BLIS are not decreasing her supply as I had long wondered
about this product.

I have tried her on high dose sage (1500 mg TID) and mint tea with no impact
on supply or MER.  Cabbage leaves work to some degree, but she hates the
smell.  I'm starting her on homeopathic Pulsatilla today and another herb
combo that is known for tx of "estrogen dominance" (based upon her reported
endometriosis symptoms).  One of my usual herbs Lycopus virginicus
(bugleweed) is not growing just yet because it's still winter here and is
really hard to locate elsewhere.  I've also informed her that we could try a
nipple shield to both slow down the flow and to decrease the amount of
nipple stimulation (although baby doesn't really need to do much work with
her high pressure faucet).

This mom lost all her pregnancy weight by 1 week pp and has trouble keeping
weight on.  I've advised her to have a thyroid panel done for
hyperthyroidism.  I'm also concerned about pituitary issues (tumor?).  My
question is "Am I missing something?" Please email me privately as well as
to the list.  TIA!
Warmly,
Chris
--
--Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC    [log in to unmask]
INFANT CUISINE AND MOTHER CARE: Lactation Consulting, Perinatal Health
Education and Attachment Parenting Classes for parents and practitioners

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